Respiratory Infection

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Originally Posted by tbowman

This is precisely why you culture immediately, and start with a broad spectrum antibiotic such as Baytril or Ceftazadime. There's no reason to throw antibiotics at something without knowing what it is.

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This is an oxymoron. Starting broad-spectrum antibiotics before getting culture and sensitivity results is the very definition of throwing antibiotics at something without knowing what it is.

As already stated, by the time you get culture and sensitivity results, you will have already successfully treated the vast majority of cases. So, in the vast majority of cases, culture and sensitivity wouldn't change therapy, and would be a waste of time and money. You are certainly entitled to your opinion. I am just explaining the reasoning behind what is considered the standard of care. It's the same reasoning behind why humans aren't getting cultured for respiratory infections left and right. I have had many respiratory infections in my lifetime, and I suspect you have as well. I have never been cultured, and I suspect that you haven't either. You don't have to agree with the reasoning, but the reasoning is sound and is based on statistical likelihoods over large populations.

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Originally Posted by ratchet

And I'm still learning, haha, thanks for correcting me! I guess I'm the lucky one for having a vet with 35 years of experience. [emoji14] I have heard that they will give a medication right away regardless, then alter it if needed based on what they find. Thank you!

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No worries, and thank you for not getting offended or defensive. My post wasn't meant to be directed at you, per se, but was rather an attempt to educate the board a bit so that we don't end up with a bunch of folks "Burger Kinging" their vets and demanding blood cultures :D

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Originally Posted by BoiseBallz

This is an oxymoron. Starting broad-spectrum antibiotics before getting culture and sensitivity results is the very definition of throwing antibiotics at something without knowing what it is.

As already stated, by the time you get culture and sensitivity results, you will have already successfully treated the vast majority of cases. So, in the vast majority of cases, culture and sensitivity wouldn't change therapy, and would be a waste of time and money. You are certainly entitled to your opinion. I am just explaining the reasoning behind what is considered the standard of care. It's the same reasoning behind why humans aren't getting cultured for respiratory infections left and right. I have had many respiratory infections in my lifetime, and I suspect you have as well. I have never been cultured, and I suspect that you haven't either. You don't have to agree with the reasoning, but the reasoning is sound and is based on statistical likelihoods over large populations.

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I think you know what I meant.

You made the argument that you wouldn't want to have a snake languish while you wait for results from a culture.

In the event that the bacteria (presuming its bacterial) is resistant to the antibiotic you choose, you will know after three or four treatments, in which case, you'll have to go back and have a culture and sensitivity done if the snake isn't showing signs of improvement. (putting more stress on an animal with a depressed immune system)

So now it's a week after you've started treatment, the snake still isn't getting better, and you'll have to wait another week to get definitive results (hopefully). All the while the snake is suffering. I just don't quite see the benefit (other than saving money) to not having a culture done immediately.

Humans aren't being cultured for respiratory infections because antibiotics are not typically needed, and respiratory infections are not typically fatal in humans the way they are in snakes.

I'm not saying that you can't successfully treat respiratory disease without having a culture done, but I don't see any good reason other than money, not to.

Better safe than sorry.

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Originally Posted by tbowman

I think you know what I meant.

You made the argument that you wouldn't want to have a snake languish while you wait for results from a culture.

In the event that the bacteria (presuming its bacterial) is resistant to the antibiotic you choose, you will know after three or four treatments, in which case, you'll have to go back and have a culture and sensitivity done if the snake isn't showing signs of improvement. (putting more stress on an animal with a depressed immune system)

So now it's a week after you've started treatment, the snake still isn't getting better, and you'll have to wait another week to get definitive results (hopefully). All the while the snake is suffering. I just don't quite see the benefit (other than saving money) to not having a culture done immediately.

Humans aren't being cultured for respiratory infections because antibiotics are not typically needed, and respiratory infections are not typically fatal in humans the way they are in snakes.

I'm not saying that you can't successfully treat respiratory disease without having a culture done, but I don't see any good reason other than money, not to.

Better safe than sorry.

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RIs in balls are almost exclusively bacterial. Viral and fungal infections are very rare. While this isn't necessarily the case in other reptile species, it is in balls. Most ball bacterial RIs are gram negative organisms. In other words, with rare exception, you already know what you are treating.

Truly antibiotic-resistant RIs in balls are also uncommon. Failure of therapy and development of resistance is due to inappropriate dosing; inadequate or incomplete administration of dosing by the reptile owner; failure to complete the full course of therapy; failure to prescribe a full course of therapy; failure to address contributing factors such as husbandry issues; and inappropriate early switching of antibiotics - which is occasionally due to chasing inaccurate or inadequate culture results.

You say that human's aren't being cultured for RIs because antibiotics aren't typically needed, but that is not why. Human bacterial pneumonias aren't typically cultured and antibiotics are needed. Untreated bacterial pneumonia in humans isn't any less virulent than untreated ball python RIs. Also, ball python RIs aren't typically fatal.

As with sputum cultures in humans, choanal cultures in BPs are unreliable and prone to inadequate sampling as well as cross contamination (see above re: chasing cultures) . I doubt that you are advocating tracheobronchial lavage (lung washings) routinely.

Are you advocating anaerobic, fungal, and viral cultures as well? If so, that's quite an expensive routine workup. If not, I would be curious to know why. It would be somewhat hypocritical for your reasoning to be that these tests would only likely add unnecessary expense while rarely effectively changing therapy.

I'm not going to continue to go round and round on this. I believe I've explained the reasoning behind practicing evidence based medicine, and I doubt anything I type will change your opinion. I'm not saying that what you are advocating is horribly unreasonable or is bad medicine, but it isn't evidence or outcome - based.

At this point, I think it would be most reasonable to agree that we respectfully disagree.

Cheers

Not saying this in the interest of starting/continuing an argument, but unless the cost is going to be prohibitive I prefer to get any reasonable tests/cultures done before treating. Not an RI, but I had a snake come down with a typically mammalian parasite a few years back. The vet initially wanted to do a general treatment, but I decided to wait on the fecal to be done before treating. Had we waited till the general treatment failed to do the test it would have certainly been much worse (if not too late). Considering the amount of stress it puts on reptiles to go to the vet and get the meds in their system, I just personally prefer to get as good an idea as possible before treating to minimize the amount of times they have to go through that.

That being said, I do understand the logic behind doing a general treatment first, and there are upsides to both strategies. It's just down to the keeper to decide what works best for them.

Some symptoms will have the same generic drugs and culture tests are meant more as assurance for the owner than as a truly needed diagnostic test. Other symptoms may be caused by a more variable infection. I think it is a good idea to treat with broad spectrum antibiotics when in any doubt. If it is something else, those antibiotics may have prevented a serious secondary infection.

For future reference, for those of you that do believe in the F10 SC in the nebulizer method of treating mild RIs, do you add 3ccs or 5ccs of the product to 1 liter of water?

Also, how many air holes should the tub you are using to treat the snake in have in it? I'm assuming it needs some unless the nebulizer provides enough oxygen during the 40 minute treatment time?

I have used f10 sc to treat a very minor case of RI in a female ball that i got from a show it cleared it up she had no signs at the end of 10 days of treament and been fine ever since i had the f10 sc so i gave it a shot i did the way Brian fro bhb said on a you tube

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Originally Posted by chosen2030

For future reference, for those of you that do believe in the F10 SC in the nebulizer method of treating mild RIs, do you add 3ccs or 5ccs of the product to 1 liter of water?

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The appropriate concentration is 1: 1000 . That is a 3cc dose of f10sc to a 1000cc of distilled water. Remember this is in no way a substitute for actual herp vet examination and treatment. It's usually for a mild case of RI but is better facilitated as a adjunct to other vet supported therapy. The ventilation holes should be placed in a way that there is adequate oxygen exchange for the animal. Make sure to place paper towels in the tub the reptile is in so as to absorb the condensation and droplets from the nebulization. Then place the tub in a larger tub with the connections of the tubing for the procedure. Make sure to advise your vet about the procedure and get his approval beforehand.